I have been placed on a PPI called omeperzole I
Currently take 20mg twice a day for server acid
Reflux disease. The doctor told me that she has
Never seen acid reflux this bad in a 24 year old.
So far I been taking the medicine for about 2 month
I have not yet seen a change in the symptoms. She said that I would have to take this medication the
Rest of my life. Is it time to start thinking about
Having the acid reflux surgery to help fix this?
hi joshua,
i used to take ppi called nexium 20mg 2x/day too.
make sure you take it correctly, it HAS to be taken at least 1/2hr before meal. if taken without meal, the efficacy is reduced 30%
have you done any test eg. helicobacter test, endoscopy, barium meal test?
if you have helicobacter, you have to erradicate the bactery first with antibiotics, otherwise you won't get well
the endoscopy can tell you whether you have gastrtis, ulcer etc
barium meal test is for gastroparesis -delayed stomach emptying
allergy tests to find out whether you are allergic to gluten, lactose intolerrant etc
the ppi is just to make your stomach produce less acid, but it wont fix the underlying condition. with less acid, even if you still reflux, the reflux wont damage your esophagus and will let the your esophagus to heal itself in time.
same as you after 4 months with ppi i didnt feel any imrovement in my symptoms.
my doc performed an endoscopy on me that everything was actually clear.
apprently my esoohagus has developed sensitivity (you can google 'functional heartburn'
so even with normal reflux and weak acid i still felt the pain.
my doc then prescribed me amitriptyline (anti depressant) startling with low dosage 5mg gradually up to 30mg.
after that i felt slighly better but still feeling bloated and belching all the time.
it's confusing because the symptomsof reflux, sensitivity are the same.
and then i realized 1 of the side effect of nexium is bloating.
apprently with less acid produced by the stomach, it can cause indigestion as well because our stomach need proper acid to digest food.
so now i gradually reduce my nexium dosagefrom 40mg to 30 then 20 then at themoment 10mg....i actually feel better now.
don't forget the diet too. you have to find a suitable diet for yourself, as everyone is different.
i bought jamie kouffman book 'dropping acid', you can find it on amazon if u are interested.
but above all, i'd suggest you find out if you have any underlying problem that causing the reflux,
good luck joshua!
Hi Joshua
I have taken 2 x 20mgs of Omeprazole for several years and am OK with it.
However I would say - this should have kicked in after a few days as it is a good drug for stopping the acid... A bit weird the Dr has told you you will need to be on it long term if it isn't helping you after 2 months.
I had the op 3 months ago. It is an option you can look into if your symtoms don't stop
DId you doctor say to change your diet and way of eating along with taking the tablets? That is very important.
Vicky, that was one of the best responses I have read here on this forum. Very informative and helpful. I hope there are more people like you with your experience on the board.
Joshua, stay vigilent and positive. Figure out when you start to have your issues and then try to think back to figure out what may be causing it. The docs are there to treat and we have to play the detective to figure out the route cause. Nightime seems to be a big issue for most. I can only add something basic to vicky's response and that is prop yourself up at night. Add blocks to the feet of your headboard or frame or sleep on a wedge....Don't eat for 4 hours before bedtime and drink very little if you have to. Koufman's book is essential.
Hi Joshua/Vicky,
I was 34 when I started experiencing problems. I am so so worried about this condition. I went to doc with indegetion after an umbilical hernia repair and then further investigation revealed gallstones. Gall bladder whipped out! May be check if you have gallstones?
Anyway, that was supposed to be the end of the matter but unfirtunately I have suffered ever since with nausea and pain. I have had 3 endoscopies............1. Severe infalmmation, 2. completely normal, 3. Bile reflux, minor inflammation. My biopsies came back clear but I am still worried this may be cancer.............I had the biopsies done 8 months ago and my doctor is saying that is the end of the road, there is nothing more they can do................should I fight for more tests? More endoscopies? My daughter is only 6, I can't beleiev this is happening to me.
I hope you get a good doctor Joshua...............push for an ultra sound, then an endoscopy, PPI's have never worked for me, the only thing that seemed to have any effect was Antepsin and that is no longer available in the UK. Why do I get inflammed stomach but to Helico B, No ulcer? I am sure it must be something serious and it is stressing me out!
thank u abc1234
i'm glad if my reply could help.
hi paul,
i know how you feel. i can so relate. i have young kids too.
so your gallbladder has been taken out? i dont have any personal experience on this but you might be interested to jeremy bernal book 'the gallbladder survival guide'. i heard it's very useful.
if your tests all came back negative but you still feel the pain, maybe it's functional heartburn. my doc described func heartburn as 'sensitive nerves'. apparently after having reflux for too long, my esophagus nerves became sensitive, and they translate everyting as pain to my brain. it's like when we have a cut on our finger, the cut has healed but when we touch it, it's still painful.
my suggestion'd be if u go to see your doc again, ask for a possibility of func heartburn. as i said earlier my doc prescribed me with low dose amitriptyline to calm down the nerves. when i googled, i saw some other docs use different types of anti depressant drugs to tackle this eg gabapentin, klonopin, etc all with small dosage. but my doc said amitriptyline is 1 with the lowest side effect and easier to get off.
good luck paul!
Thanks I appreciate it.
Yes in very concerned for the both of us. I will try my best to pursue more test.
Yes she told me to change my diet I have
Done so but I cant risk of me only being 115 pounds to risk of losing anymore weight. So that's why I have thought about having the
Surgery to fix it. My doctor has not said
Anything to me about the surgery I just been doing research and found that its a option
I really don't want to take a medication that's
Not working for me you know. I would much
Rather go through with having the operation
That way I'm not loosing anymore weight
And I don't have to take a life long medicine
I'm just at a lost of words. Is it ok to mention
To my doctor if I wanted the operation is that my right to decide if I want it or not?
Joshua, before you decide to go for surgery, maybe you can ask your doc to do esophageal impedance & ph monitoring test. These tests are to check whether your esophagus is working properly and whether you indeed have abnormal reflux.
The endoscopy can tell whether you have physical prob like hernia.
If all tests are positive, then maybe surgery is the answer.
I talked to my doc the other day about surgery option. And he said many people still have the same or even worse symptoms after surgery as every surgery comes with a price (you alter your body). And the surgery- (fundoplication is the gold standard) is irreversible.
Therefore I think it's important to do the tests above before going down for surgery. The surgery is to 'tied-up' your esophagus so you won't reflux, but if your tests above are negative (which means you don't reflux) then surgery won't change anything or even make you worse.
I learnt the hardway that symptoms of stomach probs are overlapping to each other. which means I can have reflux problem with bloating but without heartburn, or gastritis with heartburn but without stomach pain etc.
If you do need surgery, then think of options like linx etc. Ask your doc what options you have.
If you are considering surgery if it was me I would go see Dr. Koufman in NY. She is the last stop when it comes to acid reflux. If not go see the best in your state. If you want to gain weight eat more of what is allowed and do some approved exercises. If none of these are something you agree with then go meet some past surgery patients and hear their story of what surgery has done for them. I personally would be very hesitant to have surgery.
Hi Vicky, really grateful that you got back to me and sorry for taking so long to reply. I don't want to bother you but you do seem to have a lot of info that no one has ever really talked to me about before and it would be great if you could give me a bit more advice.
The background you know and to be honest some of what you have talked about makes me really think my problems could be related to my mental health...........I know this sounds crazy but if I drink alcohol (not to excess but maybe 2 or three glasses of wine) my symptoms seem to go entirely.............it makes me think that I may be completely stressed with my life and that that is what causes the problem to always be there.
I am a teacher, I work hard, I do a lot of childcare with my daughter, I do not feel too stressed but maybe it has manifested itself in my stomach? Do you think that is possible? I know most people with these issues are the opposite to me they think that they are not stressed but the doctor thinks it is mental......may be I am the other way round?
I am sort of grasping at straws but I am willing to try anything and it is the first time anyone has linked my issue to anti depressants (I mean you feel they may possibly help me).
I will order the book you suggested too but I have to say that changing diet has not really made any difference to me but I will say that weirdly the more excessively I eat the better my stomach feels and that is affecting me mentally and again conversely to everyone else, I am gaining weight!
My specialist has said he will give me a Ph test but I have to wait until March, I just want to feel better, I always had an iron stomach and I never thought this would happen to me especially at my age, I am so so anxious and any help that you have given me up to now has been really gratefully received. How did you get on after you started the Anti D's? Thanks again. Paul
hi paul, sorry for the late reply. my condition has been up and down especially that i've been trying to reduce my nexium, well it's been hard.
how are you going btw? i'd say that before you go down to take anti depressant drug, you'd better take all the necessary tests to rule out other possibilities e,g. gastritis, ulcer, gastroparesis, hernia, etc.
With the anti depressant drug, (i use amitriptyline) my doc advised me to start with a very small dosage then gradually increase it every week or so, so i started at 5mg and gradually increased it to now 30mg. my doc said the effective dosage for stomach nerve hypersensitivy is between 30-50mg but some people might need up to 75mg. The effect of the drug is not immediate, and for me it took about a month at 30mg to experience some relief. some other docs use different type of anti depressant drugs like citalopram, gabapentin, klonopin, etc which one is more effective apparently is different from 1 person to person, so it's abit of trial and error.
pls consult with your doc first before trialling any drugs as some are not easy to get off from e.g nexium.....
Hi Vicky, really sorry to hear you haven't been well...........I am at the stage now where when I next see my gastro specialist I am going to demand better treatment. He even had the nerve to say I had been on his books for a long time. All I want is a diagnosis!! I couldn't agree with him more, 3 years and still with no diagnosis and no new treatment. I really struggled last week but I only see the Doc every 6 months!! I am now dosing myself up with Domperidone which seems to be the only thing that even touches the sides of this illness and helps me to get to work.
I am sooooooooooooo depressed! I was always so well, and now everything has turned upside down. I just wish I could get a diagnosis and then I could decide what to do, I am willing to pay for any op if necessary. I am going to push my Doc for Ph testing and an improvement in my treatment and more frequent appointments as I have been extremely patient to date. As my wife says (she is Chinese) "A crying Baby Gets The Most Milk", in o ther words, be nice and polite and expect to be at the back of the queue, kick and scream and you should get what you are entitled to. I need to be more Bolshie!!
Any way, what is Nexium? Is it a PPI and has it helped you in anyway and why are you coming off it? In some ways I am glad PPI's haven't helped me, it seems as though lots of people have trouble with them in the long term. On the other hand I wish I could get to the bottom of my problems! Taking 3 Domperidone a day at the moment and that can't be a good thing! Hope you find a way through, we are all in this mess and it is great having your input and support. Paul
Be very careful with how much Domperidone you take as this is most recent advice:
Domperidone (Motilium) is associated with a small increased risk of serious cardiac side effects. Its use is now restricted to the relief of nausea and vomiting and the dosage and duration of use have been reduced. It should no longer be used for the treatment of bloating and heartburn. Domperidone is now contraindicated in those with underlying cardiac conditions and other risk factors (see below). Patients with these conditions and patients receiving long-term treatment with domperidone should be reassessed at a routine appointment, in light of the new advice
hi paul,
if you find domperidone/motilium helps making you feel better, i'd suggest you put gastric emptying test as your first priority testing. domperidone is used to speed up gastric emptying in gastroparesis.
derek76 is right, every medication has its own side effect unfortunately 
so unless the benefits outweigh the side effects, then try your best to avoid it.
as for my case, i'd tried my best to avoid nexium (ppi drugs) as i was so afraid of the side effects, but unfortunately my gerd got worse and worse to the point that i gave up and had to take nexium. and my delaying of taking nexium has caused my esophagus to develop hypersensitivity. how i wish now that i had taken nexium earlier!
while waitinig for your test, i think you had better avoid food with high fibre and fat. those are the no no food for gastroparesis as they are harder to digest.
and it's sad isnt it? some docs enter this profession without passion at all!
if i were you i'd find another doc. if your doc is uncaring, no matter how hard you 'scream' at him, his nature is still uncaring, and the last thing you want is if he just makes up any diagnosis and shoves you with a cocktail of medication to 'shut' you up.
I am not sure, but I think he ruled out gastroparesis although I have not done any specific test, I think he took blood to etst for diabetes and he said that was negative so ruled it out. I am sure it is something to do with what you say, don't wat to go in to too much graphic detail (!!) but I never fully empty when I go to the toilet and ever since I started on the domperidone 3 times a day (only been on it for 1 week so far) I have really, really improved although still not compleetly better but compared to last week when I was just sooooo ill, it's like chalk and cheese. I agree with Derek and am grateful for his advice but, honestly I have just been doing this for a week and like you I aim to stop when I go to my specialist in March. No way I could have got through Christmas feeling as I did, now I am quite looking forward to it!!
How do I go about requesting a new doctor? I thought once my GP referred me that I was stuck with whichever specialist I was given. I was not aware that I may be able to request a different hospital or specialist. It is funny, when I feel a little better I am sure that I can't be seriously ill and i believe my doctor when he says that (and I can accept my clear endoscpy biopsies) I do not have anythings erious wrong with me. When I am ill and my stomach is inflammed I am sure that I haev something serious. At teh moment I am just grateful that I can function and am really grateful for your help and support even though you must eb sick of these massively long posts!
So what next for you? How is your Doc? Do you get anywhere with them and what are their suggestions for you? Is it acid reflux you have or are you still waiting for a definitive diagnosis.
well, from what i read, most gastroparesis sufferers are diabetic due to nerve damage, but not all of them, some people could get gastroparesis from just a bout of stomach flu. you can google what causes gastroparesis to find out. the only way to rule out gastroparesis is by taking the gastric empyting study. you can google this too to know how the test is done.
so you had done your endoscopy and the result is clear? that's good news! 
at least we can rule out ulcer, gastritis, esophagitis, helicobacter and hernia
where do you live btw? i live in australia. here we need to get a refferal from our gp to see a specialist. i usually search my 'own specialist' by asking for recommendations of good doctors from friends or health forums or google search and then mention it to my gp to be referred to that doctor. i had a bad experience when i just let my gp refer me to any specialist that came up on his list! and if i'm not happy with the specialist, i'd come back to see my gp and ask his help to refer me to a new one. unfortunately in ozi specialist consultations mostly are not covered by insurance, but the good thing is we can decide ourselves which doc we want to see without any interference from insurance company.
as for me now, well, i've been reducing nexium since sept! everytime i reduce the dosage, i'd get acid rebound and the hypersensitivity makes it worse, coz i get confused whether the pain comes from acid rebound, hypersensitivity or the real reflux coming back... my doc is actually against me reducing nexium, but since i started nexium, i've got low vit d and my iron's so low that i keep feeling lethargic not to mention the bloating side effect from nexium, but i know without nexium my esophagitis wouldnt have healed....
well good luck paul. if u can try to find abetter doc that can really help you.